世界中医药

目的：探讨半夏白术天麻汤辅助针灸治疗经行头痛患者的临床疗效，及对血清学指标的影响。方法：选取2016年12月至2017年12月在南京中医药大学附属南京市中西医结合医院接受治疗经行头痛患者89例为研究对象。按照半夏白术天麻汤辅助针灸治疗与单纯针灸治疗2种方式分为观察组（n=45）与对照组（n=44）。比较2组临床疗效及血清学指标变化。结果：治疗后，观察组一氧化氮（104.65±12.41）μmol/L、人前列腺素F2α（PGF2α）（27.13±9.59）pg/mL、人前列腺素PGE2（PGE2）（32.66±5.48）pg/mL与PGF2α/PGE2（0.85±0.22）。对照组一氧化氮（92.39±13.85）μmol/L、PGF2α（33.84±10.51）pg/mL、PGE2（27.78±3.45）pg/mL与PGF2α/PGE2（1.17±0.43）。观察组治疗后升压素（AVP）（173.36±15.35）pg/mL、纤维蛋白原（3.04±0.28）g/L、以及内皮素-1（ET-1)（85.94±13.27）pg/mL。对照组治疗后AVP（182.18±22.45）pg/mL、纤维蛋白原（3.84±0.39）g/L、以及ET-1（102.81±16.02）pg/mL。观察组治疗前中医证候积分（15.95±0.38）分和治疗后中医证候积分（3.84±0.24）分。对照组治疗前中医证候积分（15.79±0.42）分和治疗后中医证候积分（6.85±0.37）分。治疗后观察组疼痛程度改善值（1.57±0.68）分与疼痛时间改善值（1.56±0.59）分，对照组疼痛程度改善值（1.10±0.45）分与疼痛时间改善值（1.08±0.29）分。观察组治疗无效2例，总有效率为84.15%。对照组治疗无效11例，总有效率为75.00%。结论：半夏白术天麻汤辅助针灸治疗经行头痛的临床疗效显著，提升血清一氧化氮与PGE2水平，降低凝血率，防止瘀血导致脑部血液循环不通造成的经行头痛。

English Summary:

To study the clinical effects of Banxia Baizhu Tianma Decoction combined with acupuncture for the treatment of meridian headache and its influence on serological indexes. Methods:From December 2016 to December 2017，89 patients who received the treatment of headache in Nanjing Integrated Traditional Chinese and Western Medicine Hospital were selected retrospectively and were randomly divided into the observation group (n=45) and the study group (n=44). The observation group was treated with Banxia Baizhu Tianma Decoction combined with acupuncture while the control group was treated with acupuncture alone. The clinical efficacy and changes of serological indexes before and after treatment were compared between groups. Results:1) Determination of serum NO and prostaglandin:after treatment in the observation group，NO was (104.65±12.41) μmol/L，PGF2α was (27.13±9.59）pg/mL，PGE2 was (32.66±5.48）pg/mL and PGF2α /PGE2 was (0.85±0.22). In control group NO was (92.39±13.85) μmol/L，PGF2α was (33.84±10.51) pg/mL，PGE2 was (27.78±3.45) pg/mL and PGF2α /PGE2 was (1.17±0.43). 2) Plasma level:after treatment in observation group，AVP was (173.36±15.35) pg/mL，fibrinogen (3.04±0.28) g/L and ET-1 was (85.94±13.27) PG/mL. After the treatment in control group，AVP was (182.18±22.45) PG/mL，fibrinogen was (3.84±0.39) g/L and ET-1 was (102.81±16.02) PG/mL. 3) TCM syndromes scores:the total score before and after treatment in observation group were (15.95±0.38) and (3.84±0.24) respectively. In control group，the total score before and after treatment were (15.79±0.42) and (6.85±0.37) respectively. 4) The pain index of observation group and control group:after treatment in observation group，the pain degree improvement value was (1.57±0.68) and pain time improvement value was (1.56±0.59). In control group，the pain degree improvement value was (1.10±0.45) and pain time improvement value was (1.08±0.29). 5) After the treatment，of the 46 patients in observation group，2 cases were ineffective，and the total effective rate was 84.15%. In control group，of the 44 patients，11 cases were ineffective，and the total effective rate was 75%. Conclusion:The clinical effect of Banxia Baizhu Tianma Decoction combined with acupuncture is remarkable for the treatment of meridian headache，and it can improve the content of serum NO and PGE2，reduce the probability of coagulation，and prevent the headache caused by cerebral blood circulation obstruction.

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